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� � <br /> i — - — - <br /> I RCW 64.55 MULTI-FAMILY CERTIFICATION WORKSHEET <br /> I CITY OF EVERETT PERMIT SERVICES <br /> ��� 3200 Cedar Strect Lveretl,�V�98201 �'� �'3 ��y <br /> I 425-7�7-P,P10-FAX A7fi�257�8857 -v,vr�rve'ett,v�org <br /> . �(�/I� �oiS <br /> � REHABILITATIVE CONSTRUCTION, NEW CONSTRUCTION, RECORDED COVENANT OR CONVERSION <br /> '`oNE� �/�iln 9ti 6 �c �aice S3Z0 .�H_2d--J-- B�ti il-ai5 <br /> IBO% ProPehy Name�--—�---�— Address � B�Id�ng N�,i�,be� Pcrr 1 N�,rnber �. <br /> fl REHABILITATIVE CONSTRUCTION equal to or less than 5% or less of current assessed <br /> market improvement value of specified building' <br /> 'NOT[ Apphcan!to prowtle entne cost of rehabd�tatrve construct�on to the bui'dmg enclosu�e 1or a multwnd li <br /> �'�., residential bwlding or mized use pro�ect per RCW 64 55 010,which may e■ceed the valuat�on for badding permit <br /> I'� (A1 ENCIOSURE REHA�COSTi(8J�dUI71PLV(A�AY 100�(C)ASSFSSFD�UILDING V�l UG (D�.UIVIPE �A)by(C) _ _ <br /> -- -- - - -- <br /> I �r� NEW CONSTRUCTION OR REHABIUTATIVE CONSTRUCTION equal to more than 5% rt <br /> current assessed market improvement value oi speci(ied building' <br /> 'NOTG Pcr RCW G4 55 010.RCW 64 55 070 and RCW 64 55 060 <br /> I'� Each bu��ding endosure design document is to be stamped and signed by a Washmgton State architecl The �. <br /> � documents should a'so conta�n a stamped s�gned statement by Ihe same arch�tect Ihat"the unders�gred has <br /> , provided butldmg enclosure documenis that m my prolessional�udgment are appropriate to sa65fy Ihe requirements <br /> or RCW fi4 55 005 through 64 55 090 . <br /> F�nal msped�on or 'Certiflcate of Occupancy' cannot be issued by the buildi�g department pnor to rece�pt of a <br /> �. s�gnea letter from an mdependent mspeclor cert�fy�ng lha� Ihe bwldmg enclosure has been inspected dunng the <br /> course of wnslrucUon and has been construcled �n su6stanUal comphance witl� the bwtd�ng enclosure desgn <br /> documents <br /> ICI RECORDED COVENANT OF SALE from Snohomish County' <br /> , 'NOTE Sale Prohibition Covenanl per RCW 64 55 010 <br /> Submd sde plan wdh location of build�ng. perm�t with desoipl�on of work and cerhfied copy ol recorded tovenant <br /> � Irom Ihe real property records ol Snohomish Cou�ty. Washngton �oi spenficd binidir.g <br /> ❑ CONVERS�ON lo condominium' <br /> �I 'NOiF. permds may be required by thc Cily ol Everep per Ihe results of ihe indepenAcnl �nspecUon report <br /> �I Undersigned wdl comply with owner independent mspedion allemalrve per RCW 64 55 090 and RCW 6A 34 40012) <br /> SignaWre ol Ownei or Aulhoraed Agent Pnnted name ol CKner or Authonted Agenl Phone N �. Date <br /> Pnnted name ol�us�ness ` Address ' Gty� Z�p Code <br /> _ - -- -- z 3j3 � � <br /> chAlsancwcomandcando(rcv7ll�1 FOROfPICf?USfONI.Y � <br />